Mammograms and Breast Health

Why Have Breast Exams?

In order to determine disease in the body screening tests are used. In the case of breast health, there are a variety of ways to check for disease when there are no apparent signs or symptoms. The primary focus of breast screening is to discover if there are any unusual growths that could be problematic - specifically, cancerous tumors or lumps.

If a woman finds a lump in her breast by doing a self-exam, or if the lump is found because it could be felt, then it is more likely the disease has spread. Conversely, lumps that are found through screening breast exams tend to be much smaller and, consequently, still confined to one area of the breast.

Early detection is a key to saving lives, and the use of various methods of screening help to ensure a woman has the best chance to circumvent a serious situation when it comes to breast health. One method of breast examination that has proven to be important and valuable in discovering some cancers is mammography. The American Cancer Society suggests that women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health.

Women at High Risk

Women who are high risk for cancer should have a mammogram as well as an MRI. An MRI, while more sensitive in that it is more likely to detect a cancerous growth than a mammogram, may still miss some cancers that a mammogram may detect. So, using both methods for women who are at increased risk for breast cancer is often done. Breast x-rays have been done and used as diagnostic tools for more than 70 years, however, it wasn't until 1969 that mammogram equipment was developed to address the specific need for breast x-rays with low levels of radiation.

According to the American Cancer Society, high risk women are those who:

· Have a known BRCA1 or BRCA2 gene mutation

· Have a first-degree relative (immediate family) with a BRCA1 or BRCA2 gene mutation, but have not had genetic testing themselves

· Have a lifetime risk of breast cancer of 20% to 25% or greater, according to risk assessment tools that are based mainly on family history

· Had radiation therapy to the chest when they were between the ages of 10 and 30 years

· Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have first-degree relatives with one of these syndromes.

Women who are at moderately increased risk for cancer are those who:

· Have a lifetime risk of breast cancer of 15% to 20%, according to risk assessment tools that are based mainly on family history

· Have extremely dense breasts or unevenly dense breasts when viewed by mammograms

Diagnostic and Screening Mammograms

A diagnostic mammogram is an x-ray of the breast used to diagnose breast disease in women who exhibit symptoms, or who have had an abnormal result on a screening test. A screening mammogram is done on a woman who has no symptoms of breast disease and appears to not have any problems with her breasts. As long as a woman does not have implants or is not breast-feeding, the normal number of x-rays taken is two views per breast - each view at a different angle. Women with implants or who are breast-feeding (or have dense breasts) may require additional x-rays because of the difficulty in getting accurate pictures with high-density breast material.

The mammogram will give the doctor specific information that helps define changes that could be problematic. Some of the changes the doctor will look for are calcifications (mineral deposits within the breast tissue), a mass, and cysts:

· Macrocalcifications are larger calcium deposits that are most likely the result of aging. They are usually related to non-cancerous conditions and don't require a biopsy.

· Microcalcifications are tiny deposits - speck of calcium - in the breast. They are more of a cause for concern but don't necessarily mean cancer is present. Both shape and layout of the spot helps the doctor determine whether it is cancerous or not. If there is a suspicion of cancer, a biopsy will be done.

· Masses can be many things, including non-cancerous cysts. They could also be cancer.

· Cysts can be fluid-filled sacs or partially-solid and they are usually benign and a biopsy isn't necessary. A solid tumor or complex cyst may be a cause for concern.

If you are a woman over the age of 40, it is to your benefit to get a mammogram once a year. Regular self breast exams and clinical breast exams are important as well. Early detection saves lives.